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General NPI Number Information
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NPI Number | 1477424554
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Entity Type | Individual
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Provider Name | TRINITY FAITH CEPHAS
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Gender |
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Dates
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Enumeration Date | 09/13/2025
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Last Update Date | 09/13/2025
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Provider Practice Location Address
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Address Line | 8200 PROFESSIONAL PL STE 107
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City | LANDOVER
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State | MD
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Zip | 20785-2293
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Country | US
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Telephone | 301-710-8270
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Fax |
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Provider Business Mailing Address
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Address Line | 3880 SMITHVILLE RD
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City | FEDERALSBURG
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State | MD
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Zip | 21632-2460
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Country | US
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Telephone | 443-477-5878
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 33643
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License Number State | MD
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